Individual
PHILIP DAVID GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 MEDICAL PARK AVE, NEW BERN, NC 28562-5248
(252) 633-1678
(252) 633-1403
Mailing address
PO BOX 12248, NEW BERN, NC 28561-2248
(252) 514-6685
(252) 514-2745
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23705
NC
207Q00000X
Family Medicine Physician
23705
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036C
BLUE CROSS
NC
05
—
891036C
—
NC
Enumeration date
09/01/2005
Last updated
09/01/2011
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